Quitting opiates, taper or cold turkey?

WantToBeReborn

Bluelighter
Joined
Jan 24, 2014
Messages
271
Hi all

As per the title, I want to beat this demon for once and for all.

Long story short, prescribed morphine for chronic pain and now sick of the use/quit/binge cycle and the dose going up and up. Have used it to cope with some very emotionally painful times in my life when my coping mechanisms ran out, but now I want to try and get my life sorted.

Have a few sleeping pills but nothing else and my doc is reluctant to give me anything else due to medical issues ongoing.

Can anyone share how they reduced or stopped opiates or even just where they are in the journey towards quitting and recovering? How long does it take to feel "happy" again or even just not profoundly depressed?
 
Ok, I've managed to get some Gabapentin 300mg and some Lyrica 50mg. Can anyone explain how these actually help opiate withdrawal?
 
Hey want2be and welcome to Bluelight and to TDS and recovery=D

restless leg syndrom and neropathic pain are often some of the worst symptoms of opaite witdrawl.. these have been linked to low GABA. Both lyrica, Gabapentin, and phenibut are GABA analogs so buy taking these we increase them adressing the dificaincey caused by opiate withdrawls.


some links
Restless Legs Syndrome
Restless Legs Syndrome Fact Sheet

medications for acute opiate detox

The medications I would explore the use of for detox would be:
>Clonidine< DOSED EVER FOUR HOURS..

one of either
>NEURONTIN< >HERE< >HERE<
OR >Lyrica<
OR >phenibut<

>A BENZO BUT JUST AT NIGHT<
>a nsaid<
>melatonin<
tylenol

(Opi Withdrawal) what is the best comfort meds for opiate w/d?

PAWS LINKS
Why We Don’t Get Better Immediately: Post-acute Withdrawal Syndrome (PAWS)
Post Acute Withdrawal (PAW) Excerpted From “Staying Sober” By: Terence T. Gorski
Post-acute-withdrawal syndrome Wiki
http://www.clairedorotik.com/NLWC-EXERCISE_AND_MOOD.htm after the acutes are over!
ADD take http://www.bluelight.ru/vb/threads/673580-Hey-I-thought-the-grey-matter-of-ADD-could-chew-on-this
Managing depressive thinking

it is a powerful thing to keep our thoughts possitive and here are some threads many of us use to help us do this.
Good things about being off drugs/getting sober
Share something POSITIVE from your day!
Today I Am Thankful For... Ver. 3: Earth, Wind and Fire!


some really good information about what you are going to concur=D
 
Great info, thanks!

Great username too! Man, to be free of this continuous sickness....I've forgotten what "normal" feels like.

Since I started trying to reduce my opiates, I have noticed I am ridiculously tired, I mean, bone tired, will this get better once I am fully clean?
 
Thanks W2Breborn=D

The fatigue and tiredness was one of the worst symptoms for me as well. It was also one of the last symptoms to disappear. It was really bad for until the acutes lessened after three weeks... and then got just s sliver better each day until it disappeared when my opiate receptors were finally retracted back into the cell membranes from the cells which had sprouted them because of prolonged use. But I dont think you will have such a rough ride as I jumped off 150 mgpd methadone, 260 mgpd roxie, and 6 mgpd xanax 8(.. I used methylphenidate in combination with the clonidine to combat it. What is the opiate (s) that you are detoxing from if you want to share?
 
Nsam - appreciate the words of support and wisdom as this is a tough battle as you know!

Can you tell me a bit more about this receptor thing as I have read before about something similar and that the brain develops extra receptors or something?

What is methylphenidate? Again, heard this mentioned before. My doc won't give me clonidine so that is a no no. Very inexperienced doc in terms of opiate withdrawal protocol - expects me to just stop the meds with no comfort meds by slow taper over months!! Something more aggressive but not quite cold turkey would be better as I can't do this for months.

No stranger to a massive poly drug cold turkey detox but would not go there again after the last time nearly killed me, literally, but once I get my current dose down a bit, I may try and jump off and see how bad it gets.

This time around I will be dumping morphine and zopiclone (sleepers) but the sleepers won't go until I have stabilised the morphine withdrawal. I've been tapering for some time and now almost below 100 mg per day between extended release morphine tablets and fast release liquid morphine. Not sure how to introduce the lyrica/gabapentin though.
 
Methylphenidate is a stimulant >here<. I t is addictive and so I dont promote its use that much. Also it isn't a good idea to take it for opiate withdrawals unless you have clonidine on board as it manipulates the adrenals. The purpose of having the clonidine is to limit the unusually high adrenal response to detox. So if a person takes the methylphenidate without having the clonidine on board the will likely have more negative symptoms then positive ones.

methylphenidate
amphetamine salts
"Dopaminergic agents (drugs that increase dopamine), largely used to treat Parkinson's disease, have been shown to reduce symptoms" of restless legs.. and they work on other syptoms as well like th fatige and depression.. >source<

But the use of these drugs needs to be seriously considered as they are for sure have addiction potential and assessed if attempted as they can certainly have a negative effect for some people.

Good news thats its morphine as this has one of the shortest half lives and thus has one of the shortest withdrawals. So you are really only looking at five days in the tunnel once you jump=D

I would consider seeing a different doctor to obtain the proper medications. There is really no need to feel so rough for those days. The way i would bring up the idea of the GABAs is that restless legs and neuropathic pain are usually some of the worst symptoms of opiat detox and this medication is used to combat both of these symptoms. Also you may tell them that you have seen many testimonials of people who have detoxed from opiates saying it really was a life saver. Here is a thread in OD where allot of people speak well of the use of GABA. Also the Phenibut is available online and not regulated in allot of places.

Your Personal Opiate Withdrawal Arsenal

Yeah I just admitted to myself that i cant taper.. just awful at it.

your only five days away from freedom=D also do you have a plan for combating the PAWS?
 
Interesting info.

Five days? It took fifteen days on last cold turkey due to coming off massive doses, but getting blood poisoning and other life threatening issues didn't help. So straight cold turkey isn't an option even though tapering sucks. How much is too much to drop in a day or a week is the real tricky question.

My ct withdrawal never last five days. The 12 hour slow release tablets seem to take forever to clear but I have weird metabolic shit going on too.

Phenibut sounds good, must look into it. No doc will give me clonidine due to medical issues it seems. But the gabapentin and lyrica might help right? Is 300 mg gabapentin too much to start at?

No plan for PAWS yet, need to sort a plan for sure!!

Hang on...parkinson's drugs? I have Sinemet, could this help?
 
for gabapentin

The Tarascon pocket Pharmacopoeia recommends starting with 5 mg/kg at bed and then 5 mg/kg twice a day on day two and then 5mg/kg three times a day on day three. then titrate to usual effective level of 8-35 mg/kg/24h This would be the dose if you were not planning on taking the lyrica as well. Im not sure I would use both of these at the same time as they are so similar. If you already have these then there is no need to get the phenibut as its pretty much the same thing. I think the gabapentin is the best drug out of the three for opiate detox. Also you dont want to stay on these for a very long time as they can cause physical dependence.


The Sinemet could help but it also has a chance of kicking up your addictive drive.. If you look at post 4 in this thread and click on the dopamine video you will see what I am talking about. The Brain and Addiction (under construction)

Here is also another good thread to take a gander at Addiction Guide

I do realize that the acutes last longer than five days but the majority of people I see who are kicking morphine get to that day where they start to feel much better right around day five.. the light at the end of the tunnel day=D
 
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Handy info on the dosing for gabapentin/lyrica.

I can't medically do ct this time hence why I've been tapering for so long - so unfortunately there will be no light at the end of the tunnel in five days for me - but the lyrica should start to make this taper more bearable.

A friend who also detoxed from morphine use of continuous long duration high prescribed doses of 1000mg per day + also did a partial ct recently and tapered first and even titrating the dose right down first, cold turkey then still took way longer than five days too. Sure, that five day starting to feel better thing might be possible from a short/light habit, but it just doesn't tend to happen that quickly in established high dependence/long duration morphine use, especially with medical patients on massive doses who often tend to have other shit going on. Another friend's withdrawal from a colossal morphine dose for around a decade solid, had barely got going after the first three days ct as there was just so much morphine still in their system, but they were then very sick for about 12 days after that and hospitalised for dehydration.

Will look at that sinemet stuff, looks interesting.

I had 100 mg lyrica just there and it made me nicely drowsy which was wonderful but it seemed to wear off fast. Can this stuff be redosed within an hour or two of taking it?
 
Hi there OP...welcome to BL. NeverSickAnymore is the best go to person for info on opiate withdrawals as you can see...he has tons of good info. I am a little curious (if you dont mind sharing any pertinent info) you keep mentioning medical issues..do you mind saying what they are? As a nurse, I just had a few concerns for you about use of some of the stuff plus the issues that go with withdrawals..

Good luck and just remember, there IS a light at the end of the tunnel..
 
Hi there OP...welcome to BL. NeverSickAnymore is the best go to person for info on opiate withdrawals as you can see...he has tons of good info.
Thanks missme=D


I checked a little into the question we were exploring and found this

Dopamine Precursors and Agonists for Restless Legs Syndrome

If you are already in poor health then I would not just automatically take all these drugs for the detox and I would clear them through a phisitian to make sure that you are not going to take something that may affect you in a negative way.<3
 
Hi again, great links Nsam! Loving all this information!

Just to clarify, my detox is being overseen by my doc (physician) and he is aware I am doing research on detox methods. This same doc is fully aware of my medical history. Everything I suggest or request is cleared through him.

Missmeyet - thanks for your lovely message. The medical stuff is very complex - luckily it has no real bearing on my reducing opiates, that was my choice as my tolerance/dependence was increasing frequently - not a good situation!

Glad to have had some sleep last night - thanks for the support and great info! The PAWS stuff is interesting, how long did that stage last for you Nsam?
 
I'll add another factor in case anyone in a similar situation reads this.

When I first decided to quit all opiate pain meds, I had researched a phenomenon called "opioid induced hyperalgesia" which basically means when chronic pain patients keep increasing doses, the opioids themselves increase pain levels and alter pain timings, breakthrough pain, etc. In my experience, this is correct. When I last quit all pain meds for several years, the underlying pain decreased without opiates and I didn't have the big pain spikes that come with intra-dose withdrawal.

When my situation worsened, I returned to pain meds, now I am back to trying to quit to see if the pain decreases again.
 
The Acute withdrawal lasted about a month and a half and the paws seemed to be pretty light for me... dont get me wrong I had them but I was really putting allot of effort into managing them.. I radically changed the way I thought about life, I threw all the guilt and shame out the window for good, I identified the roots of my addiction and worked on and solved as many pieces as I could identify, I used testosterone replacement therapy as a testosterone check on me indicated that I was WAY below normal levels. I keep moving through the acutes and started to exercise during the paws, I used techniques to limit my negative emotions, such as mindfulness and keeping all my thoughts firmly in today as if we slip into yesterday we can get hit with guilt, shame, anger, resentment, and if we slip into tomorrow we can get hit with fear, anxiety, hopelessness, stress.. etc.

It is clearly documented that addicts develop an unusually strong "A dysfunctional Emotional response." Emotions for humans are the evolutionary way unconscious has developed to influence and manipulate the conscious into doing what it wants done. If we use a drug to try and quite an emotion or one whose side effect is a decrease in them, and pain can be looked at as a localized emotion, then the brain ramps up the power of its emotions to try and compensate for the addition of the drugs. The brain likes its homeostasis and it does things like tolerance, and the heightening of emotions to try and return the brain to where it naturally is. So the idea of "opioid induced Hyperalgesia" Makes total sense to me.. Because if my thoughts on the brain ramping up its emotional response combine with the undeniable aspect of tolerance.. then as the brain wramps up the pain and decreases the effectiveness of the pain medication through tolerance then this would could increase the pain. There is another way of possible explaining this as well.. the portion of our brains that is addicted is also the same place that causes the sensation of pain. In fact all the symptoms of acute and post acute withdrawal are centered right in the hypothalamus.. and it may be possible that the limbic system is able to identify that by increasing the pain it is able to get us to take more of the substance it is obsessed with.

It could be that the acute withdrawal are the period it takes for the brain to adjust back to it homeostasis with out the drug in the equation and then the Paws is a mix of a few things. One we have logged all kinds unsolved problems that are tagged with and emotion, as solved. We need to go back into the system and clean it out.. for the mix of a bunch of emotional problems that are unsolved combined with a painfully high emotional response is a terrible mix to have to deal with. So it is important to find away to clean the system.. one approach that works well for people are portions of the stepes from the fellowships. Its a confession and the power of telling someone else your problems and secretes is so powerful that it has been attributed to god for thousands of years. I dont want to get into a debate about the fellowships or god in your thread as thats not it purpose. But it may also just be a way we have evolved, because people who felt good about sharing their problems were probably more successful in life the more people the better for working on a problem. The making amends to the people we have harmed has a bunch advantages, the first one is it helps clean out all the negative emotions associated with those events and it may help rebuild relationships.

There a diffrent ways of dealing with this issue, but this is one of the most popular techniques.

The 12 Steps of Narcotics Anonymous
Alternate version of the twelve steps

There is a huge silver lining to the hugely strong emotions.. once you learn how to manipulate them through techniques that limit the negative emotions and promote the positive ones then people can experience utterly amazing positive emotions as well ;)

Here are some threads that are good at promoting positive emotions..

Today I Am Thankful For... Ver. 3: Earth, Wind and Fire!
Share something POSITIVE from your day!

so when ever we get all miserable it pays to stop and switch how we are choosing to percieve what is going on at that moment.

The Paws can apparently last up to two years.. but this is a really extreme case. When my opiate receptors finally shut down a week before the fifth month the symptoms which had been getting a tiny bit better everyday disappeared. The pain specialist I talked to gave a timeframe of seven and a half months as when he thought most peoples shut down.. I think this is just an average as people seem to kinda get better at different rates and things like exercise, healthy natural sleep, exercising many different facets of the brain, and nutrition may play a really positive role in promoting healing. So anyway like I said just before month five I all the sudden got really tired and slept for twelve hours a night for three days after only sleeping 4 hours a night for almost five months. when I woke up all my symptoms had disappeared basically.. the pain was gone, the goosebumps that had sailed a demented path all over body were gone, and my mind became so clear it was amazing.. I had no idea what a fog i was in as I thought I was pretty clear headed after the acutes passed.. man I was wrong. It was like going from a beat up old four cylinder car to a V8 and then it got even better over the next six months.

So it good to have a plan in place to deal with the Paws and I hope some of this helps you out. =D

PS. If you want to share what disease you are struggling with you may get some good responses about that as well.
 
NSAM - what a superb response. I have been doing a lot of learning about the physiology and emotional components of addiction so this stuff is really helpful. Also have joined NA already and started working on understanding my behaviour and thought processes. I have seen the compulsiveness and low impulse control and black and white thinking and "victim" complex in myself and others and I do recognise the importance of altering my sometimes detrimental and self-destructive negativity. So, thanks for this.

You really are a credit to this board. I can't thank you enough for all the effort you've put in to providing this invaluable information. The PAWS element does worry me. But your description of your recovery is inspiring and motivating! I have forgotten what "normal" feels like. The fatigue, low mood, etc is insane.

As you say, the hormone profile does undergo profound changes with opiate use. Hypogonadism is common in both males and females. I have also had altered female hormones, pituitary issues, blood sugar issues, sleep/wake cycle issues and a number of other issues, which I am growingly increasingly convinced may well be related to long term, high dose opiate use. This field is still highly misunderstood by ordinary medical doctors. My research is indicating that opiate use does indeed potentiate significant changes to human physiology.

I'd be happy to discuss the physiology side further and appreciate your knowledge and insight - you are clearly someone whom has invested significant work in your recovery and in furthering your and others' knowledge of addiction. Great to see you paying it forward!
 
I'm a believer of cold turkey, it only last 3-4 days (worst part) then lingers on for a few weeks (insomnia, lower back pain, act)... people who taper using sub/methadone usually just get dependent on this and decide not to taper because they feel great.
 
Taper, taper, taper!!!!

I tried a lot of "just quit now" type cold turkey withdrawals. None worked.

Tapering barely got me off bupe 45 days ago.

Either way make plans so it's bearable
 
I think I explained above why I cannot do cold turkey for medical reasons. It is a fallacy that anyone can do cold turkey. Those on ultra high doses of opiates for a long duration with additional medical complications can not and should not attempt to stop opiates suddenly. Captain Heroin is on the money here - well done on your clean time!

I am not tapering using subs or methadone - it is a straight taper by gradual reduction with NO replacement opiates. The goal is for me to be completely opiate free.

Moving on, the last time I did a cold turkey detox - which I did after an uneducated doctor actually told me the same story - stop cold and the withdrawals will be over in under a week, however it did not pan out this way at all, quite the opposite.

Let me explain something about quitting high dose long term medical grade opiates cold - it is dangerous and no form of detox from massive doses of medical opiates should be attempted without medical supervision. It puts a huge strain on the heart and other organs. Medical grade pharmaceutical prescribed opiates are a known quantity and never "weakened" or cut with anything, so tolerance is rapid and with pain, can grow massive quickly, compared to opiates that are degraded with other compounds for non prescribed purposes, sale, cutting them for sale etc.

I found out that cold turkey can be dangerous, the hard way, the last time I did a cold turkey detox. It nearly killed me. I ended up in intensive care with over 14 days in hospital, almost a week after I started detox. That was 21 days in total, NOT including post acute withdrawals. I was so sick and dehydrated and my potassium level so low by the time I was rushed fo hospital that I was told it was a miracle I did not have a heart attack. After ten days solid of throwing up and shitting water, all day and all night, even with 40 + litres of fluids put back in by IV line, I became so dehydrated that my organs shut down, then I got septicaemia (blood poisoning).

So I am not exaggerating when I say that cold turkey detox from medical opiates almost killed me and it certainly did not last 4 days. In fact, the first five days, I had so many opiates still in my system (the liver can only process so much at a time and perform gluconeogenesis as well, especially in those that can't hold any food or drinks down) that I hardly felt any withdrawal. I thought I was better after the first five days!! Then, BANG! It hit me like a volcano! My withdrawal and sickness lasted over 21 days NOT including PAWS and almost cost me my life. Of course, this is not the everyday experience, but still, I would never advocate cold turkey detox to any medical opiate patient - we simply do not know their medical background or complications.

Painkiller users like me tend to end up on colossal doses of opiate meds, because when chronic pain signals are present, opiates have a specific action and tolerance occurs quickly, then increased pain signals appear and higher and higher doses of opiates are needed to control the increasing pain. I have personally experienced this - at doses up to 1000mg+ of morphine per day, I still kept having pain and repeated withdrawal every four hours or less. Specifically, I had huge pain spikes at certain times, during withdrawal every four hours when the huge opiate doses were creating demand and increased pain in my body every four hours. The miracle was that when these opiates were all stopped eventually, I was almost pain free within a matter of days, hugely reduced pain and certainly not four hourly pain like when I was slamming constant opiates.

I know others will say they cold turkeyed in a few days and that is great, however I wanted to share my story, since so many medical opiate users are ending up in a similar situation, whereby they are left to manage detox on their own and it can go catastrophically wrong.
 
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I was going to post in this thread but, after seeing the textbook that neversick basically compiled with all those good posts... I'm not even going to try. Hah.

Wish you the best, OP. Withdrawal is a real nightmare but everything ends eventually.
 
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